One of the most important aspects to remember when discussing the topic of sex and disability is that people with disabilities are sexual beings. Oftentimes, people assume that those with disabilities have no sexual desires or needs and tend to treat them as children or victims in need of protection. In reality, the majority of people with disabilities have the desire and capability to maintain rich and fulfilling sexual and romantic relationships. Even people experiencing severe disabilities are likely to experience sexual arousal, romantic attraction, the desire for intimacy, and love.1 It is true that certain disabilities can create obstacles to traditional sexual scripts and modes of expression, which is why it is even more important that people with disabilities have access to information regarding sexual health and relationships. It is imperative that people with disabilities have access to information about how to maintain positive relationships, how to protect against sexually transmitted infections (STIs) and pregnancy, how to achieve greater sexual pleasure, how to choose an appropriate partner, and more. While disability can have an impact on a person’s sexual and romantic life, it does not have to be a negative impact.

Different Types of Disabilities

There are many different types of disabilities that may influence a person’s sexual and romantic life. Some of these disabilities may include the following:

Some people may experience one of these disabilities or a combination of multiple disabilities; additionally, everyone experiences their disability to a different degree. It is important that those living with a disability maintain open and honest communication with sexual and romantic partners about their level of disability and how it affects their relationships and sexual needs. While all disabilities can influence sexual experiences and relationships, there are some disabilities that tend to have more social stigma attached than others when it comes to sexuality.

Intellectual Disabilities

Intellectual disabilities tend to be categorized in stages of mild, moderate, severe, and profound. These categories are measured by a number of different factors, including basic IQ, developmental skills (speech, motor skills, etc.), physical characteristics, basic learning skills, social functions, and need for supervision.2 In many societies, people with mild and moderate intellectual disabilities are able to participate actively in social life and live on a semi-independent or independent basis. In general, most people who are intellectually disabled experience sexual feelings, save for a small portion of profoundly disabled people.1 Additionally, intellectually disabled people have the ability to identify as a distinct sexual identity such as gay, lesbian, transgender, bisexual, or asexual, just as any other person does.1

The constitutional right to privacy grants people with intellectual disabilities the same right to privacy that any other person might enjoy. However, those with intellectual disabilities also have the right to protection from sexual exploitation in the case that they are not able to give consent. The issue of granting sexual freedom while also offering protection from exploitation can be a difficult one to manage; many people debate over whether or not those with intellectual disabilities are truly able to give consent.1 However, the truth is that most intellectually disabled people do possess the mental capacity to give consent; often what they lack is education regarding topics such as sexual practices, various sexual orientations, appropriate partners, privacy, exploitation, STIs, pregnancy, masturbation, pornography, and more.1 In reality, it is the propensity for societies to shelter those with intellectual disabilities from learning about sexual health and education that impedes the opportunity for the intellectually disabled to have safe and healthy sexual relationships.

Physical Disabilities

Physical disabilities occur when some aspect of a person’s physical functioning is affected by their disability; this may include changes in a person’s mobility, dexterity, stamina, or sensitivity.3 Common examples of physical disabilities include cerebral palsy, spina bifida, poliomyelitis, paralysis, head injury, spinal cord injury, loss or deformity of limbs, and muscular dystrophy, among others.4

Paralysis and spinal cord injuries in particular can pose unique challenges to sexual expression. Sometimes people experiencing these physical disabilities can completely lose sensation and movement below the neck or in the lower half of the body.1 The ability to maintain or achieve an erection, to ejaculate, to flex the penile or vaginal muscles, to experience vaginal lubrication, and to experience sensation differs based on each person and the level of their injury or paralysis. Some tools can be used to aid in these scenarios, such as the use of Viagra to help males with spinal cord injuries who wish to obtain erections and the use of personal lubricant to help females who cannot experience natural lubrication.1 Additionally, there are certain sex positions that can work better for partners who have limited mobility, as well as sex toys, such as swings and straps, that may add functionality and spice to the sex lives of those with physical disabilities. Ultimately, the most important tool for those living with physical disabilities is open and honest dialogue between partners. Tactics like sensate focus,sensual massage, and playful touch can often prove more erotic and pleasurable than any traditional methods of penetrative intercourse. The key to any healthy and happy sex life lies in each partner’s ability to be vulnerable, trusting, adventurous, and open to trying new things.

The Importance of Sex Education

Unfortunately, the accessibility of accurate sexual information is already so limited in many places that oftentimes those with disabilities find it nearly impossible to access information about sex—especially sexual health information that is designed with anyone other than able-bodied people in mind. Sadly, many people with disabilities even report being told to leave the room during school presentations about sexual health because teachers perceived the information to be either irrelevant or inappropriate for them.5 Just as it is important for all people to receive age-appropriate sex education, it is highly crucial that people with disabilities receive this information as well. Sex education can empower people with disabilities to make responsible sexual choices, including knowing how to have safe and pleasurable sex, knowing how to please oneself using masturbation and other tactics, knowing how to protect against STIs and pregnancy, knowing how to recognize and give affirmative consent, and knowing how to protect oneself against an abusive partner.6 All these educational subjects are just as important for people with disabilities to learn about as they are for any other member of society. Parents and guardians of those with disabilities should keep this in mind and should work with doctors and educators to make sure their loved one with disabilities gets accurate and comprehensive sex education. After all, as many studies have shown, increased sex education does not increase sexual activity, it simply increases safety when participating in sexual activities.7

Sexual Service Providers

Due to both physical and social situations, people with disabilities often find themselves seeking sexual contact but remaining unable to access it. This lack of sexual experiences can lead to sexual frustration and psychological distress. As a result, the modern age has seen a rise in the existence of sexual service providers, also known as sex surrogates, that specialize in meeting the needs of those with disabilities. Responsible sexual service providers recognize that those with disabilities may want to experience any of the following situations:

Good sexual service providers take into account the sexual, physical, mental, and emotional needs of their clients.8 While sex surrogacy is not technically legal in most countries, there are still many organizations and individuals who offer sexual services to people with disabilities. In the Netherlands—where prostitution is legal—people with disabilities can spend a portion of their medical benefits however they like, and some official reports stipulate that one use of those benefits could be obtaining sex services up to 12 times per year.9 The Netherlands leads the way in recognizing sex as a basic human right and in making sure those with disabilities have access to sex if they want it. Some sex workers do not feel sex surrogacy should be legalized because that will lead to intense regulation; instead, they suggest that sex surrogacy—and all sex work—should be decriminalized so that consenting adults can make private decisions without fear of being prosecuted, fined, or arrested.10

Overall, sexual services can be a life-changing way for people with disabilities to experience sexual pleasure, often for the first time; alternatively, sexual service providers may also become a normal, routine part of life for a person with disability and provide them with sexual satisfaction on a regular basis. Whether a person with disabilities is seeking to experience a first kiss or a wild sexual fantasy, sexual service providers can be a safe, exciting, and fulfilling option.

Concluding Remarks

The most important thing to remember is that people with disabilities are fully capable of desiring and achieving healthy sexual and romantic relationships. It is imperative that people with disabilities receive comprehensive sexual education, including information about protecting against STIs, giving and recognizing consent, understanding pregnancy and childbirth, understanding signs of healthy and unhealthy relationships, masturbating and achieving orgasm, and more. While some disabilities may raise questions of choice and competency while others may present issues of functionality, almost all aspects can be overcome with positive communication and access to sexual health information and services. People should not assume that those with disabilities are sexually incompetent, asexual, or incapable of performing sexually or feeling sexual arousal. Instead, people with disabilities should be treated with dignity, respect, and equality when discussing topics of sexual health and relationships; people with disabilities are a crucial part of the dialogue and literature regarding sexual health and romance. Sex is a fundamental human right, and everyone deserves equal access in the pursuit of sexual and romantic fulfillment.